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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2016-01035 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| Winship3258-16 | Other Identifier | Emory University/Winship Cancer Institute |
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This phase II trial studies how well tacrolimus, bortezomib, and anti-thymocyte globulin (thymoglobulin) work in preventing low toxicity graft versus host disease (GVHD) in patients with blood cancer who are undergoing donor stem cell transplant. Tacrolimus and anti-thymocyte globulin may reduce the risk of the recipient's body rejecting the transplant by suppressing the recipient's immune system. Giving bortezomib after the transplant may help prevent GVHD by stopping the donor's cells from attacking the recipient. Giving tacrolimus, bortezomib, and anti-thymocyte globulin may be a better way to prevent low toxicity GVHD in patients with blood cancer undergoing donor stem cell transplant.
PRIMARY OBJECTIVES:
I. To determine a composite end point of alive and severe acute GVHD free at 6 months following human leukocyte antigen (HLA) matched related or unrelated donor hematopoietic peripheral blood transplant in patients with hematologic malignancies who receive the immunosuppressive combination tacrolimus, bortezomib, anti-thymocyte globulin (TBT) as GVHD prophylaxis.
II. To determine the safety of this combination in the first six months post-transplant.
SECONDARY OBJECTIVES:
I. To determine the cumulative incidence of grade III-IV aGVHD.
II. To determine incidence and severity of chronic GVHD.
III. To determine disease relapse or progression overall and disease free survival at one year.
OUTLINE:
Patients receive tacrolimus intravenously (IV) on day -3 through day 180. Patients may receive tacrolimus orally (PO) later at the doctor's discretion. Patients receive anti-thymocyte globulin IV on days -3, -2, and -1 and bortezomib IV on day 0 and day 3. Patients undergo allogeneic bone marrow transplant on day 0.
After completion of study treatment, patients are followed up for 6 months and then periodically for up to 2 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tacrolimus, bortezomib, thymoglobulin | Experimental | Patients receive tacrolimus IV on day -3 through day 180. Patients may receive tacrolimus PO later at the doctor's discretion. Patients receive thymoglobulin IV on days -3, -2, and -1 and bortezomib IV on day 0 and day 3. Patients undergo allogeneic bone marrow transplant on day 0. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thymoglobulin | Biological | Given IV |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total Number of Serious Adverse Events and Adverse Events Related to This Immunosuppressive Regimen | An adverse event (AE) is defined as any untoward medical experience or change of an existing condition that occurs during or after treatment. All AEs occurring during this study, whether observed by the physician, nurse, or reported by the patient, will be graded per NCI CTCAE version 4.0 and recorded on protocol-specific case report forms. A serious adverse event (SAE) is defined as any expected or unexpected adverse event (AE, generally equivalent to CTCAE grades 3, 4 or 5) that results in any of the following outcomes:
| Up to 6 months post-transplant |
| Number of Patients Alive and Free of Severe Acute GVHD Following HLA Matched Related or Unrelated Donor Hematopoietic Peripheral Blood Transplant | Will use patient counts for the number of patients alive and free of severe acute graft versus host disease (GVHD) following human leukocyte antigen (HLA) matched related or unrelated donor hematopoietic peripheral blood transplant. | At 6 months post-transplant |
| Measure | Description | Time Frame |
|---|---|---|
| Cumulative Incidence of Grade III-IV aGVHD | Will be summarized as percentage and 95% confidence level will be also constructed. | Up to 2 years post-transplant |
| Incidence of Chronic GVHD | Will be summarized as percentage and 95% confidence level will be also constructed. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Zaid Al-Kadhimi, MD | Emory University/Winship Cancer Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Emory University/Winship Cancer Institute | Atlanta | Georgia | 30322 | United States |
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Patients were recruited from 9/9/2016 to 7/11/2017 at Winship Cancer Institute of Emory University.
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| ID | Title | Description |
|---|---|---|
| FG000 | Tacrolimus, Bortezomib, Thymoglobulin | Patients receive tacrolimus IV on day -3 through day 180. Patients may receive tacrolimus PO later at the doctor's discretion. Patients receive thymoglobulin IV on days -3, -2, and -1 and bortezomib IV on day 0 and day 3. Patients undergo allogeneic bone marrow transplant on day 0. Thymoglobulin: Given IV Bortezomib: Given IV Tacrolimus: Given IV and PO |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 22, 2016 |
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| Bortezomib | Drug | Given IV |
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| Tacrolimus | Drug | Given IV and PO |
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| Up to 2 years post-transplant |
| Overall Survival | Will be analyzed with Kaplan Meier method and Logrank test. | At 1 year post-transplant |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Tacrolimus, Bortezomib, Thymoglobulin | Patients receive tacrolimus IV on day -3 through day 180. Patients may receive tacrolimus PO later at the doctor's discretion. Patients receive thymoglobulin IV on days -3, -2, and -1 and bortezomib IV on day 0 and day 3. Patients undergo allogeneic bone marrow transplant on day 0. Thymoglobulin: Given IV Bortezomib: Given IV Tacrolimus: Given IV and PO |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Total Number of Serious Adverse Events and Adverse Events Related to This Immunosuppressive Regimen | An adverse event (AE) is defined as any untoward medical experience or change of an existing condition that occurs during or after treatment. All AEs occurring during this study, whether observed by the physician, nurse, or reported by the patient, will be graded per NCI CTCAE version 4.0 and recorded on protocol-specific case report forms. A serious adverse event (SAE) is defined as any expected or unexpected adverse event (AE, generally equivalent to CTCAE grades 3, 4 or 5) that results in any of the following outcomes:
| Posted | Number | events | Up to 6 months post-transplant |
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| |||||||||||||||||||||||||||
| Primary | Number of Patients Alive and Free of Severe Acute GVHD Following HLA Matched Related or Unrelated Donor Hematopoietic Peripheral Blood Transplant | Will use patient counts for the number of patients alive and free of severe acute graft versus host disease (GVHD) following human leukocyte antigen (HLA) matched related or unrelated donor hematopoietic peripheral blood transplant. | Posted | Count of Participants | Participants | At 6 months post-transplant |
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| Secondary | Cumulative Incidence of Grade III-IV aGVHD | Will be summarized as percentage and 95% confidence level will be also constructed. | Data were not collected because trial closed early. | Posted | Up to 2 years post-transplant |
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| Secondary | Incidence of Chronic GVHD | Will be summarized as percentage and 95% confidence level will be also constructed. | Data were not collected because trial closed early. | Posted | Up to 2 years post-transplant |
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| Secondary | Overall Survival | Will be analyzed with Kaplan Meier method and Logrank test. | Data were not collected because trial closed early. | Posted | At 1 year post-transplant |
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Adverse event data were collected up to 180 days post-transplant.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Tacrolimus, Bortezomib, Thymoglobulin | Patients receive tacrolimus IV on day -3 through day 180. Patients may receive tacrolimus PO later at the doctor's discretion. Patients receive thymoglobulin IV on days -3, -2, and -1 and bortezomib IV on day 0 and day 3. Patients undergo allogeneic bone marrow transplant on day 0. Thymoglobulin: Given IV Bortezomib: Given IV Tacrolimus: Given IV and PO | 2 | 5 | 4 | 5 | 0 | 5 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Thrombotic thrombocytopenic purpura | Blood and lymphatic system disorders | Non-systematic Assessment |
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| Device related infection | Infections and infestations | Non-systematic Assessment |
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| Confusion | Psychiatric disorders | Non-systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
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| Respiratory failure | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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After monitoring early toxicity and hyperacute severe acute graft versus host disease in 4/5 patients, it was decided to close this protocol.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Zaid Al-Kadhimi, MD | Emory University/Winship Cancer Institute | 404-778-1900 | zalkadh@emory.edu |
| Mar 23, 2018 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D015451 | Leukemia, Lymphocytic, Chronic, B-Cell |
| D015464 | Leukemia, Myelogenous, Chronic, BCR-ABL Positive |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D008224 | Lymphoma, Follicular |
| D006086 | Graft vs Host Disease |
| D020522 | Lymphoma, Mantle-Cell |
| D018442 | Lymphoma, B-Cell, Marginal Zone |
| D009190 | Myelodysplastic Syndromes |
| D055728 | Primary Myelofibrosis |
| D009196 | Myeloproliferative Disorders |
| ID | Term |
|---|---|
| D015448 | Leukemia, B-Cell |
| D007945 | Leukemia, Lymphoid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007951 | Leukemia, Myeloid |
| D001855 | Bone Marrow Diseases |
| D016393 | Lymphoma, B-Cell |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
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| ID | Term |
|---|---|
| C512542 | thymoglobulin |
| D000961 | Antilymphocyte Serum |
| D000069286 | Bortezomib |
| D016559 | Tacrolimus |
| ID | Term |
|---|---|
| D007106 | Immune Sera |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
| D001897 | Boronic Acids |
| D000148 | Acids, Noncarboxylic |
| D000143 | Acids |
| D007287 | Inorganic Chemicals |
| D001896 | Boron Compounds |
| D009930 | Organic Chemicals |
| D011719 | Pyrazines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D018942 | Macrolides |
| D007783 | Lactones |
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| Unknown or Not Reported |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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